KANSAS CITY, Mo.- – The number is growing of children who have died nationwide since Swine Flu hit the U.S. in April. The child death toll Oct. 9, released by the
Centers for Disease Control and Prevention stood at 76, including 19 during the first full week of Oct. That compares with 46 to 88 deaths among children from the regular seasonal flu over the past three years.
Dr. Anne Schuchat, director of the
CDC’s National Center for Immunization and Respiratory said the statistics underscores the threat of
H1N1 and the need for flu shots in general. About 30 percent of those children who died suffered a chronic medical condition such as asthma, cerebral palsy and muscular dystrophy.
“We are seeing more illness, more hospitalizations and more deaths each week from the flu,” said Dr. Schuchat. “Virtually all the virus circulating right now is the H1N1 2009 virus."
The number of child deaths is getting the attention of parents across the metro intent on getting flu shots for their family.
“I have three children,” said Missy Dearasaugh from Olathe. “They don’t like to get a shot, but I explain it’s better to get a shot than go to the hospital.”
Dearasaugh is covered through her husband’s Blue Cross Blue Shield policy at work, but said she would pay for the shots out of pocket to guard against the family getting sick.
Katrina Huckabay who lives in Lee’s Summit agrees. She has a daughter with Juveniles Diabetes. “Alyse will get a flu shot this year,” said Huckabay who added she too is glad her insurance company covers the cost.
The Dearasaughs and Huckabays are lucky because while the CDC recommends flu shots for the general public, especially children at risk, not all insurance plans cover the cost.
“These shots are a hot topic and becoming quite contentious between parents and physicians,” said Stan Hudson, Project Director and Policy Analyst of
Missouri University’s Center for Health Policy. “In some cases, policy makers are responding. For example, some states like NY have used existing laws to mandate insurance coverage of these and other shots recommended by the CDC for children under 19.”
Seasonal flu shots are not free, but the H1N1 vaccine is paid for through tax dollars because it has been declared a pandemic. Still, doctors, pharmacies, and other public clinics can charge an administrative fee for giving a Swine Flu shot. That “fee” is not always reimbursed by insurance companies. Insurance companies who don’t cover flu shots often put the onus on customers who they label “underinsured”. For the both the underinsured and uninsured public, the cost to get a shot is cash out of pocket. And, despite
Medicare coverage available for some who fall in this group, Medicare reimbursement doesn’t always match the price private providers charge for administering flu shots.
“From the public health standpoint, it highlights the problem with relying on private insurance companies to ensure basic public health,” said Hudson.
Hudson says the problem is an example of “
health literacy” – a term used to describe the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.
“Besides the fact that it is hard for the public to get understandable information about the efficacy and side effects of the vaccine,” explained Hudson, “the real health literacy issue here is that it is all about system navigation. Knowing what coverage you have and knowing what services are covered is a big challenge for most Americans.
Hudson said he is not surprised to learn that people are upset when they learn that their insurance companies are not covering something that is recommended by the CDC.
Allen Greiner, M.D., MP.H. is a family physician and professor at the University of Kansas Medical Center.
“Sometimes with the small employer, the employer with 20 or 25 employees, they may be trying to save money on that plan and they may not always include preventive services, so we see that problem here,” said Dr. Greiner. “It speaks of two things,” explained Dr. Greiner. “It speaks to this issue of the rising cost of health care and the difficulty small employers and individuals have finding affordable coverage.”
Because H1N1 is a
pandemic, the federal government is paying for the vaccine.
But consumers still face administrative charges from some health care providers which cover the expense of the nurse, office supplies and alcohol. Administrative costs could exceed $30.
Blue Cross Blue Shield of Kansas City has modified it’s policy to include covering the administrative fees some providers are charging for the H1N1 vaccine. Health experts believe other large insurance carriers will follow Blue Cross Blue Shield’s lead and cover administrative costs for the H1N1 vaccine.
Dr. Greiner advises consumers to check their health insurance policy to make sure what their plan will cover.
If their plan does not pay for the seasonal vaccine or H1N1, Dr. Greiner says it’s worth the $25 or $30 to get the seasonal flu vaccine and the administrative fee for the H1N1 vaccine.
“If your insurance company doesn’t pay then be a smart health consumer.” Said Dr. Greiner. “Shop around, find low cost or free flu shot clinics.”
The CDC reports the H1N1 flu is now widespread in 37 states up from 27 states the end of Sept. And, the flu has returned to areas hard hit by the disease last spring. If you are uninsured or underinsured, there are plans for public health department and mass vaccination clinics. (Check with your local health department for details.)
Additionally,
Federally Qualified Health Centers (FQHCs), also known as Section 330-funded Health Centers (HCs), receive federal funding to provide healthcare to underserved populations, regardless of ability to pay. The CDC expects any administration costs to be covered by those health centers as a part of the general grant expectations, but as with all services they provide, they may charge a small fee. For health centers in your area, click
here.
